Find out what services are normally covered by dental insurance. Discover what to look for in a dental plan and some of the top providers for 2023.
Without dental insurance, it is difficult to pay for dental procedures. Even something as small as a cleaning costs around $130, while the majority of dental insurance plans provide two free cleanings each year. Treating cavities is another costly area.
Without insurance, you can expect to pay around $200 to $225 each cavity, while dental insurance covers around 50 to 80 percent of the costs, based on your provider. More complex procedures, such as a root canal are often $1,100 to $1,200, while insurance cuts these costs in half.
The exact coverage varies depending on your dental plan, so it is important you understand all the benefits before you agree to a plan. There are also a few different categories of insurance, which influence how much you pay. Some insurance providers offer discounted prices if you get bundled dental and medical insurance. Listed below are some of the top features to look for, as well as top dental insurance plans for 2022.
Types of Dental Plans
Dental plans share many similarities with traditional health insurance. One of the shared plan types among both insurance options is preferred provider organization (PPO). With PPO, your dental insurance is only available if you visit a dentist within your insurance network. While your insurance may provide limited coverage outside of the network, the out-of-pocket expenses are much higher.
Another shared plan is dental health maintenance organization (DHMO). This is meant to mimic a health insurance HMO. With DHMO, you also have a network of dentists, but all the dentists use the same rates. Unlike with PPO, DHMO coverage offers no benefits with dentists outside of your network.
Finally, there are discounts and referral dental plans. These plans are different from traditional medical insurance. Instead of getting coverage, you are responsible for all the costs out-of-pocket, but receive discounts for using a participating dentist within the network. These are good options if you are unable to afford dental insurance and cannot get coverage from your work.
What is Covered
While the exact coverage varies depending on your insurance provider, there are several services covered under most plans. Almost all dental insurance plans provide coverage for preventive care. This includes your annual cleanings as well as fillings, crowns and tooth extractions. Most providers also cover limited oral surgery, root canals and dental bridges. Preventive care is either covered in full or offered at a substantial discount, sometimes up to a maximum, such as two cleanings per year. Other services provide a smaller, but still generous discount.
Each dental plan has a maximum cap on how much coverage is available. The cap for dental insurance is much lower than medical insurance. Many plans offer between $1,000 and $1,500 in annual coverage. Anything above this cap, you are responsible for paying. While this may seem limiting, keep in mind you use your dental insurance significantly less than medical insurance. Dental only covers one area, while medical insurance represents the majority of your medical needs.
Another consideration is whether your dental insurance covers cosmetic surgeries. Most dental plans only provide coverage if the procedure is medically recommended. Certain procedures, such as getting dental implants or teeth straightening are considered cosmetic and are paid out-of-pocket. However, if your dentist says you need the implants to improve your oral health, it may be classified as an essential service instead. Because it varies so much depending on your plan, always check with both your dentist and insurance provider before agreeing to an expensive procedure.
Renaissance is part of a larger insurance network. Even if you are not interested in other medical insurance from Renaissance, joining their dental program opens you up to one of the largest PPO networks in the United States. As of writing, there are over 300,000 dentists in the Renaissance network.
The company also provides a wide range of customizable dental plans. On the off chance you do not live near one of the dentists in the network, you can purchase a plan that covers outside network costs. There are also special plans for children, applicants with preexisting conditions and senior citizens. Most plans have an annual maximum of $1,000, with deductibles of $50 or $150 for select family plans. There are also plans without any deductible.
Cigna is another dental provider part of a larger insurance provider. While it does not have nearly as large of a network as Renaissance, their coverage extends to almost 100,000 dentists as of writing. In terms of coverage, it is hard to find a better provider than Cigna. They only have a few insurance plans, but their plans include options for restorative and orthodontic coverage, in addition to traditional preventative care. Routine care also carries no deductible or copay.
Cigna also prides itself on not restricting who can apply for a DPPO plan, accepting individuals with preexisting conditions for no extra charges. Their cheapest plan is only $19 a month and focuses exclusively on preventative care. Other plans are priced between $30 to $35 and provide more extensive coverage, including annual maximums as high as $1,500.
UnitedHealthcare stands out for having some of the best family plans available. There are no age restrictions, ensuring children have access to the same quality of coverage as adults. Most of the plans also provide no copays for preventive service. This includes x-rays and fillings, as well as more extensive procedures. United has a large network and even provides limited coverage if you use a dentist outside the PPO.
United also offers some of the highest annual maximums of any dental provider, with some plans going as high as $3,000. Even the least expensive plans have a generous annual. They also provide special plans and discounts for senior citizens. United offers extensive coverage, but they have a limited number of plans. Make sure you carefully review each plan to understand the exact benefits.
If you are worried about staying within a network, Delta Dental is an excellent insurance provider. While Delta has an impressive network of over 150,000 dentists, they also offer insurance plans without any out-of-pocket costs for going outside the PPO. They also provide better orthodontic care compared to other insurance providers. Each plan also comes with an annual of $1,500. Basic preventative care, including annual cleanings and x-rays is covered entirely by Delta. Delta’s plans greatly vary depending on location, so you must contact Delta directly for a quote.